"Beyond Hospital Walls: From Institution to Community—Transforming Mental Health Nursing Practice"

Abstract: The global landscape of mental health care has undergone a profound transformation over the past several decades, shifting from institution-centered models toward community-based systems of care. This transition reflects evolving understandings of mental illness, human rights, recovery-oriented practice, and the social determinants of mental health. Mental health nursing has been central to this paradigm shift, with nurses increasingly assuming expanded, autonomous, and advocacy-oriented roles within community settings. This review article critically examines the historical evolution from institutional to community mental health care, the theoretical foundations guiding community mental health nursing, emerging roles and competencies of mental health nurses, and the impact of community-based practice on service users, families, and health systems. The article also explores challenges, ethical considerations, and future directions for strengthening community mental health nursing practice. By synthesizing contemporary literature, this review highlights how mental health nurses are uniquely positioned to bridge clinical care and community engagement, promote recovery and social inclusion, and contribute to sustainable mental health systems.